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Susan Ivy
Susan Ivy, Nurse (RN)
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Experience:  BSN, MSN, CNS
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Integrate, synthesize and respond on two articles

Customer Question

Integrate, synthesize and respond on two articles:

How Much Is That Kidney in the Window? by Bruce Gottleib and "Strip-Mining" the Dead: When Human Organs Are For Sale by Gilbert Meilaender. Identifying the viewpoints of Gottleib and Meilaender and further identifying/evaluating how they differ (comparison/contrast) .

(5 paragraphs, 5 sentences each (at least), using quotes from the readings)
Submitted: 4 years ago.
Category: Health
Expert:  Susan Ivy replied 4 years ago.
Hello, I may take a look at this for you, it depends on how long the articles are. Can you give us links to the articles? When do you need this completed?
Customer: replied 4 years ago.
I need this any time tomorrow (5/01/10). The articles are not long at all. I have a link for one article, but would need to scan the other, the only problem is I am not sure where to email the scanned article.

Here is the link for one of the articles.

“‘Strip-Mining" the Dead: When Human Organs Are For Sale by Gilbert Meilaender: http://findarticles.com/p/articles/mi_qa3798/is_200001/ai_n8899946/
Customer: replied 4 years ago.
I have the other article scanned and can post it via mediafire.com
Expert:  Susan Ivy replied 4 years ago.

By tomorrow I assume you mean early tomorrow? I would need at least all day tomorrow, because I have other things I have to do as well, so I had hoped that you would possibly not need this until Sunday. I'll let you clarify, but probably I will have to opt out unless you don't need it until like mid night eastern time tomorrow.

Expert:  Susan Ivy replied 4 years ago.

Please let me know what time you need this so I can opt out if you need it tomorrow ....

Customer: replied 4 years ago.
Ok.. Sunday would work as well. I absolutely have to have this by 9pm Pacific time. Here is the link for the other article. There should be three pages. Let me know if there is any complications.

http://www.mediafire.com/?yl0z3ztemdy

Thank you very much
Expert:  Susan Ivy replied 4 years ago.
So you need it by at least 9pm pacific time on Sunday? That should be no problem, and hopefully I will have it done tomorrow, but I'm going to sleep right now!
Customer: replied 4 years ago.
Perfect! Thank you!
Customer: replied 4 years ago.
I was just checking in. Please let me know if you need any additional information.
Expert:  Susan Ivy replied 4 years ago.
I am still working on it. It is a little harder than I had imagined since the arguments are not cut and dried but very philosophical so much that it is hard to tell which side the authors are on. But I'll continue to do my best and will have it too you before 9 pacific time. Thank you for your patience.

Edited by Susan Ivy on 5/3/2010 at 12:57 AM EST
Customer: replied 4 years ago.
Ok.. Thank you. I greatly appreciate it.
Expert:  Susan Ivy replied 4 years ago.
Hi. I tried to attach this, but apparently only pictures or jpegs will attach. I hope the following essay will work for you:

When reviewing the two articles for this assignment, one statement stood out to me as being very inaccurate, and clearly seemed to indicate that the author had little actual knowledge or experience with individuals with chronic kidney disease. In the article "Strip Mining the Dead: When Human Organs Are for Sale" by Gilbert Meilaender, the author mentions that transplant success rates have improved greatly over the years, yet he wonders if the "success rate" fully takes into account the "enormous amount of suffering and frustration endured by those who accept a transplant as the price of possible survival." It is this statement that my experience proves to be so false. He seems to view the post-transplant life of the individual as one of difficulty and suffering. While it is true that recipients of transplanted organs must continue to take anti-rejection medication for the rest of their lives, the inconvenience of taking medication daily is something that practically every individual puts up with at some time in their lives. While the surgical step of the process is risky to those that are alive when they donate a kidney, as well as risky for the recipient, all surgeries entail risks, but this hardly stops people from undergoing countless surgical procedures (often for reasons much less critical than for the purpose of having a functioning kidney.) In fact, he seems completely unaware of the suffering that is involved in the process of dialysis. There is little at all to back up his assumption that there is an "enormous amount of suffering and frustration endured by those who accept a transplant as the price of possible survival"

Furthermore, the cost that is saved society when a kidney transplant is achieved rather than the individual continuing on dialysis, is much greater than most probably realize, including Meilaender. For example, dialysis for one individual exceeds $40,000 per year (See article, "How Much is that Kidney in the Window." This article was written in 2000, and this was the price that was quoted at that time as the cost for dialysis). It is obvious that the price of a kidney transplant would pay for itself over and over again. Perhaps if more kidney transplants were available, it might even be a solution to our current health care crisis! This statement is made, knowing that there is currently a very high percentage of US citizens receiving kidney dialysis, and every individual requiring kidney dialysis is eligible for complete disability under Medicare, in other words, a large part of our paycheck deductions are currently going to keep those without kidneys, alive on dialysis!

Not only is money saved simply because an individual receives a kidney and can go off dialysis, but additional savings are incurred in general to society, because the recipient is soon fit enough to go back to work and to being a productive member of society themselves. The individual who remains without a kidney is tied to dialysis and rarely is able to work, but instead must be supported by Medicare.

The inconvenience one goes through for transplantation does not begin to compare with the inconvenience of one who is tied to a dialysis machine for 6 to 8 hours 3 to 5 days per week. There is much more suffering involved in the process of dialysis than merely the inconvenience of being hooked up to a machine for up to 40 hours per week. Science and technology may have advanced, but is very far from mirroring the efficiency of the kidney. In reality dialysis is an uncomfortable procedure that requires the one to first of all undergo a surgery (albeit less complicated than a transplant surgery) to create a large venous and arterial "shunt" in one arm so that a large bore needle can be inserted each day of dialysis. Yet the arterial-venous shunts don't always work as they should, sometimes forming painful clots, and frequently require surgical revision. Even if they function in exactly the way they are meant to, they still fail after a few years, and a new one must be made in another place.

In addition to having a large bore needle inserted into the arm each dialysis session, there are other uncomfortable side effects. Dialysis involves the complete removal and filtering of the total blood volume. The machinery involved does not come close to the delicate regulation of electrolytes and minerals (potassium, sodium, magnesium, calcium, and phosphorus) provided by the kidneys. Calcium loss is a real problem for chronic dialysis patients and leads to brittle bones which easily fracture. Imperfect magnesium and potassium regulation leads to painful muscular cramps and often insomnia. Poor phosphorus regulation (a breakdown product of protein) often creates constant uncontrollable itching of the skin.

In my opinion if more individuals were educated about the facts of hemodialysis in comparison to the results of kidney transplantation, as well as the actual suffering and frustration of those who undergo dialysis, there would be less reluctance to sign up for organ donation and more individuals would be open to voting in favor of laws allowing some type of financial reimbursement to individuals (and their families) when donating a kidney or other organ.

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Susan Ivy
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BSN, MSN, CNS